Isolation of People with Infectious Illnesses in Care Homes (England) Policy

Policy Statement

Despite all preventive measures, it is sometimes not possible to totally eliminate the risks of people developing a transmissible infection. When this does occur, it might be necessary to reduce the contact between anyone affected and others in order to prevent its spread and to reduce the risks to non-infected people.

People who use the service will be asked to reduce or minimise their contact with others only if the home has received medical advice that it is in their and others’ interests on account of the nature of the infection to which they are exposed. This advice will come as a result of communications with people’s GPs and local health protection teams where there is evidence that a person has a transmissible and communicable infectious illness that needs to be contained.

Scope of Policy

The home’s isolation policy applies to instances where one or more people who use the service have contracted a transmissible infection that requires a reduction of contact with other people in order to contain the spread and reduce the risks to others. It is assumed that the person, on medical advice or other grounds, will not be moved to hospital but that a conscious decision has been taken to continue to care for the person or persons within {{org_field_name}} for the duration of the illness.

The policy needs to be read in relation to other infection control policies, particularly Diarrhoea and Vomiting Outbreak Management in Care Homes (England), and Infection Control — Acute Respiratory Infection, which addresses the more common forms of infectious illness to which people who use the service and staff are susceptible. It should also be considered alongside the home’s policies Visiting In and Out of Care Homes and Visiting the Home during an Outbreak of Infectious Disease(s).

Legal Considerations

This care service will adhere to all relevant legislation, including:

the Health and Safety at Work, etc Act 1974
the Public Health Infectious Diseases Regulations 1988
the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

Under the above legislation, and associated codes of practice, {{org_field_name}} understands its legal and moral duty to ensure the health and safety of both staff and people who use the service and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

Regulation

{{org_field_name}} recognises that it must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in order to meet its legal requirement for registration with the Care Quality Commission (CQC).

With respect to infection control, the home understands that a range of regulations may apply, including:

Regulation 12: Safe care and treatment – this requires providers to assess the risk of, and prevent, detect and control the spread of, infections, including those that are health care associated
Regulation 15: Premises and Equipment – this states that premises and equipment must be clean, suitable for the purpose for which they are being used, properly used and properly maintained.

Guidance

{{org_field_name}} seeks at all times to comply with evidence-based best practice in infection control, particularly with the Health and Social Care Act 2008 Code of Practice on the Prevention and Control of Infection and Related Guidance published by the Department of Health and Social Care (the Hygiene Code).

The home understands that compliance with this guidance is an effective way to help it to meet its regulatory requirements with the Care Quality Commission under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, particularly the infection control sections of Regulation 12: Safe Care and Treatment.

In addition, the home will comply with all other relevant best practice infection control guidance.

Applicable guidance from the National Institute for Health and Care Excellence (NICE) includes:

CG139: Healthcare-associated Infections: Prevention and Control in Primary and Community Care (updated February 2017)
PH36: Healthcare-associated Infections: Prevention and Control (November 2011)

Guidance is also available from the Department of Health and Social Care (DHSC) and from the Health and Safety Executive (HSE) in the form of:

Infection Prevention and Control (IPC) Resource for Adult Social Care (2022), DHSC
Prevention and Control of Infection in Care Homes: An Information Resource (2013), DHSC
HSG220 Health and Safety in Care Homes (2^nd edition) (2014), HSE.

Specialist advice and support will be obtained from the local public health protection team and from relevant primary healthcare teams.

Definition

By “isolation” is meant a request to a person to stay and be looked after in their room with minimal or no contact with other people, visitors, staff or anyone whose health would be seriously jeopardised if they contracted the illness. In line with Department of Health and Social Care (DHSC) guidance {{org_field_name}} is not required to have dedicated isolation facilities and chooses not to have them. It considers that it can control the spread of infection effectively without moving the person from their room, which also preserves their dignity and reduces the risk of their suffering the further emotional distress that an enforced move to a dedicated isolation facility would bring.

Practice and Procedures

The home might seek to change a person’s accommodation only where it is unable to provide all the facilities needed to look after the person for the duration of their isolation.
Many people who use the service accept the need to be in isolation because they are ill, and do not seek contact with others, effectively volunteering to be in isolation. However, the home considers that it is important to seek the written consent of any person who needs to or who has been recommended to remain in isolation until free from infection.
Where people who use the service are unable to give their consent because of lack of mental capacity, the home carries out a “best interests” assessment in line with its responsibilities under the Mental Capacity Act 2005. In some cases, the home might also need to seek a deprivation of liberty authorisation, eg if an infectious person fails to understand the reasons for needing to remain in isolation and risks spreading the infection by their movements outside their room.
The home will thus make sure that any restraints imposed on the person’s freedom of movement are fully authorised and proportionate to the need and will last only as long as is necessary to control the spread of infection.
The home guarantees that it will treat every person being cared for in isolation in the context of its infection control measures with dignity and respect and will comprehensively meet their needs under those circumstances, eg by providing stimulation and activities in line with the person’s wishes and inclinations. It makes sure that once a decision has been made to keep the people(s) in isolation and their consent has been obtained it produces a specific care plan for each person affected and uses that plan to make sure that their assessed needs are fully met.
The home will continue to seek advice and guidance from relevant medical experts to make sure that the period of isolation lasts no longer than necessary to help the person get better and to contain the spread of the infection.
The home uses the individual care plan, which is developed in consultation with all involved, to determine the restrictions to be imposed on the individual. These are based on the assessed risks to the person and of cross-infection to others from any contacts.
Everyone, staff and visitors, who has contact with any person in isolation is informed of the risks and how to reduce the risks by following all infection control procedures applicable to those circumstances.
The home emphasises the importance of everyone following good infection control procedures in these particular circumstances, ie hand hygiene, the wearing of protective equipment, safe disposal of waste, etc. These measures are outlined in the home’s raft of infection control policies.

Staff Care

The home makes sure that staff coming into contact with people in isolation are aware of the risks and the need for safe practices.
The home will always seek expert advice on the issues to be addressed by a particular infection.
The home screens all care staff who are likely to come into contact with people who use the service in these circumstances for any risks to them and checks on their immunisation status (in line with its general policy on this matter). It might exclude staff who are assessed as being vulnerable to the infection or its effects, or who risk spreading it, from having contact with a person who is in isolation.

Training

All new and existing staff are trained to achieve Standard 15: Infection Prevention and Control of the 2015 Care Certificate Standards.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next Review Date: {{next_review_date}}

CH176. Isolation of People with Infectious Illnesses in Care Homes